To determine if there is a clinical significance in changing the sequence of the positive relative accommodation and negative relative accommodation findings in the standard optometric extension program routine

The purpose of this study was to determine if there was a significant difference in magnitude of the findings if the sequence of taking the positive relative accomrnodation (#20) and negative relative accommodation (#21) in the standard Optometric Extension Program routine were reversed

Improved persistence and adherence to diuretic fixed-dose combination therapy compared to diuretic monotherapy

<p>Abstract</p> <p>Background</p> <p>Diuretics are recommended as initial treatment for hypertension. Several studies have suggested suboptimal persistence and adherence to thiazide diuretic monotherapy; this study compared patient persistence and adherence with hydrochlorothiazide (HCTZ) monotherapy to fixed-dose combinations containing HCTZ.</p> <p>Methods</p> <p>Patients with at least one prescription claim during 2001 to 2003 for either HCTZ or one of the following fixed-dose combinations: angiotensin-receptor blockers/HCTZ (ARB/HCTZ), angiotensin-converting enzyme inhibitor/HCTZ (ACEI/HCTZ), or beta blockers/HCTZ (BB/HCTZ) were identified. Patients were required to be continuously benefit-eligible six months pre- and one year post-index date, and to have no prescription claims for any antihypertensive therapy six months prior to the index date. Patients were followed for one year to assess persistence, medication possession ratio (MPR), adherence (MPR >80%), and proportion of days covered (PDC) with initial antihypertensive therapy. Logistic regression was used to calculate adjusted odds ratios for persistence, adherence and PDC, adjusted for age, gender, business segment, RxRisk disease categories, average co-pay and concurrent cardiovascular-related medication utilization.</p> <p>Results</p> <p>The study cohort consisted of 48,212 patients; 72.5% used HCTZ, 13.2% ACEI/HCTZ, 9.3% ARB/HCTZ, and 5.0% BB/HCTZ. Mean age was 53.7 years and 66.5% were female. A significantly lower proportion of patients using HCTZ (29.9%) remained persistent with therapy at 12 months compared with ARB/HCTZ (52.6%; OR = 0.37, CI = 0.36, 0.38), ACEI/HCTZ (51.4%; OR = 0.38, CI = 0.37, 0.39), and BB/HCTZ (51.9%; OR = 0.38, 0.37, 0.40). Similarly, PDC was lower for HCTZ patients (32.5%) as compared to ARB/HCTZ (53.7%; OR = 0.39, CI = 0.37, 0.40), ACEI/HCTZ (50.9%; OR = 0.42, CI = 0.40, 0.43), and BB/HCTZ (51.3%; OR = 0.44, CI 0.42, 0.45). MPR was also significantly lower for HCTZ patients as compared to those using fixed-dose combination therapies.</p> <p>Conclusion</p> <p>Initiating HCTZ fixed-dose combination therapy with an ACEI, ARB, or BB was associated with greater persistence and adherence as compared to HCTZ monotherapy. Further research is needed to determine the relationship between improved persistence and adherence with blood pressure control.</p

A high-power Ka-band free electron maser, defined by a 2D – 1D Bragg lasing cavity

One of the on-going research programs, at the University of Strathclyde, involves the development of high-power, pulsed, Free-Electron Masers (FEMs) with the lasing cavity defined using periodic corrugations on the drift-tube walls 1-4 . These corrugations form 1D and 2D Bragg resonators, whose reflection bands determine the dominant resonance of the maser 5 . Proper selection of the FEM undulator magnetic field strength, allows for efficient extraction of energy from a mildly relativistic (400 - 500 keV) electron beam at the resonant frequency of the lasing cavity, leading to monochromatic output at power levels of several tens of megawatts and pulse durations of ~150ns (determined primarily by the pulse duration of the driving power supply of ~250ns)

An Extensive Census of HST Counterparts to Chandra X-ray Sources in the Globular Cluster 47 Tucanae. II. Time Series and Analysis

We report time series and variability information for the optical identifications of X-ray sources in 47 Tuc reported in Paper I. The eight CVs with secure orbital periods have fainter accretion disks, in the V band, than field CVs with similar periods. These faint disks and the faint absolute magnitudes (Mv) of the 47 Tuc CVs suggests they have low accretion rates. The median Fx/Fopt value for the 47 Tuc CVs is higher than that of all known classes of field CV, because of both the faint Mv values and the relatively high X-ray luminosities (Lx). The latter are only seen in DQ Her systems in the field, but the 47 Tuc CVs are much fainter optically than most field DQ Hers. Some combination of magnetic behavior and low accretion rates may be able to explain our observations, but the results at present are ambiguous, since no class of field CV has distributions of both Lx and Mv that are consistent with those of the 47 Tuc CVs. The radial distribution of the X-ray detected active binaries is indistinguishable from that of the much larger sample of optical variables detected in previous WFPC2 studies. The X-ray properties of these objects are consistent with those of active binaries found in field studies. One reasonable and one marginal candidate for optical identification of a quiescent LMXB was found (one is already known). Finally, we study the blue variables showing little or no evidence for X-ray emission. Their generally long periods and the absence of flickering suggests they are not CVs. At present we have no satisfactory explanation for these objects, although some may be detached WD-main sequence star binaries.Comment: Accepted for publication in Astrophysical Journal. 34 pages, 24 figures, 5 tables, abridged abstract. Some figures at reduced resolutio

Costs of streamlined HIV care delivery in rural Ugandan and Kenyan clinics in the SEARCH Studys.

OBJECTIVES/DESIGN:As antiretroviral therapy (ART) rapidly expands in sub-Saharan Africa using new efficient care models, data on costs of these approaches are lacking. We examined costs of a streamlined HIV care delivery model within a large HIV test-and-treat study in Uganda and Kenya. METHODS:We calculated observed per-person-per-year (ppy) costs of streamlined care in 17 health facilities in SEARCH Study intervention communities (NCT: 01864603) via micro-costing techniques, time-and-motion studies, staff interviews, and administrative records. Cost categories included salaries, ART, viral load testing, recurring goods/services, and fixed capital/facility costs. We then modeled costs under three increasingly efficient scale-up scenarios: lowest-cost ART, centralized viral load testing, and governmental healthcare worker salaries. We assessed the relationship between community-specific ART delivery costs, retention in care, and viral suppression. RESULTS:Estimated streamlined HIV care delivery costs were $291/ppy. ART ($117/ppy for TDF/3TC/EFV [40%]) and viral load testing ($110/ppy for 2 tests/year [39$51/ppy), recurring costs ($5/ppy), and fixed costs ($7/ppy). Optimized ART scale-up with lowest-cost ART ($100/ppy), annual viral load testing ($24/ppy), and governmental healthcare salaries ($27/ppy), lowered streamlined care cost to$163/ppy. We found clinic-to-clinic heterogeneity in retention and viral suppression levels versus streamlined care delivery costs, but no correlation between cost and either retention or viral suppression. CONCLUSIONS:In the SEARCH Study, streamlined HIV care delivery costs were similar to or lower than prior estimates despite including viral load testing; further optimizations could substantially reduce costs further. These data can inform global strategies for financing ART expansion to achieve UNAIDS 90-90-90 targets

Experimental study of microwave pulse compression using a five-fold helically corrugated waveguide

This paper presents the experimental study of microwave pulse compression using a five-fold helically corrugated waveguide. In the experiment, the maximum power compression ratio of 25.2 was achieved by compressing an input microwave pulse of 80 ns duration and 9.65 GHz to 9.05 GHz frequency swept range into a 1.6 ns Gaussian-envelope pulse. For an average input power of 5.8 kW generated by a conventional traveling wave tube, a peak pulse output power of 144.8 kW was measured corresponding to an energy efficiency of 66.3%

Chandra X-Ray Observatory Observations of the Globular Cluster M71

We observed the nearby, low-density globular cluster M71 (NGC 6838) with the Chandra X-ray Observatory to study its faint X-ray populations. Five X-ray sources were found inside the cluster core radius, including the known eclipsing binary millisecond pulsar (MSP) PSR J1953+1846A. The X-ray light curve of the source coincident with this MSP shows marginal evidence for periodicity at the binary period of 4.2 h. Its hard X-ray spectrum and luminosity resemble those of other eclipsing binary MSPs in 47 Tuc, suggesting a similar shock origin of the X-ray emission. A further 24 X-ray sources were found within the half-mass radius, reaching to a limiting luminosity of 1.5 10^30 erg/s (0.3-8 keV). From a radial distribution analysis, we find that 18+/-6 of these 29 sources are associated with M71, somewhat more than predicted, and that 11+/-6 are background sources, both galactic and extragalactic. M71 appears to have more X-ray sources between L_X=10^30--10^31 erg/s than expected by extrapolating from other studied clusters using either mass or collision frequency. We explore the spectra and variability of these sources, and describe the results of ground-based optical counterpart searches.Comment: 36 pages including 7 figures and 8 tables, accepted by The Astrophysical Journa

Design and experiments of a five-fold helically corrugated waveguide for microwave pulse compression

Metal waveguide can be used as a dispersive medium to convert long duration, lower power pulses into short, higher peak power pulses. This provides an advanced method to generate radiation with gigawatts power in the millimeter and sub-millimeter wavelength range by compressing a megawatt level long duration pulse. In this paper, a five-fold helically corrugated waveguide operating in X-band was designed and constructed. The experiments conducted show that a 5.75 kW average power microwave pulse with a 6% bandwidth and duration of 80 ns can be compressed into a 144.8 kW, 1.6 ns pulse with a power compression factor of 25.2

Angiogenic Factors Stimulate Growth of Adult Neural Stem Cells

The ability to grow a uniform cell type from the adult central nervous system (CNS) is valuable for developing cell therapies and new strategies for drug discovery. The adult mammalian brain is a source of neural stem cells (NSC) found in both neurogenic and non-neurogenic zones but difficulties in culturing these hinders their use as research tools.Here we show that NSCs can be efficiently grown in adherent cell cultures when angiogenic signals are included in the medium. These signals include both anti-angiogenic factors (the soluble form of the Notch receptor ligand, Dll4) and pro-angiogenic factors (the Tie-2 receptor ligand, Angiopoietin 2). These treatments support the self renewal state of cultured NSCs and expression of the transcription factor Hes3, which also identifies the cancer stem cell population in human tumors. In an organotypic slice model, angiogenic factors maintain vascular structure and increase the density of dopamine neuron processes.We demonstrate new properties of adult NSCs and a method to generate efficient adult NSC cultures from various central nervous system areas. These findings will help establish cellular models relevant to cancer and regeneration